Heterotopic Ossification of Tendo Achilles: An Uncommon Clinical Entity

Heterotopic ossification of tendo Achilles (HOTA) is an uncommon clinical condition with unknown etiology. However, there are noted factors associated with this condition including trauma, metabolic conditions, infections, and genetic predisposition. The diagnosis can be made clinically and radiologically. We are reporting a rare case of HOTA managed surgically.

A 48-year-old healthy man with no history of trauma presented with pains and swelling of the posterior aspect of the left ankle and lower calf. The local examination revealed mass about 2 inches above the left ankle. A plain radiograph revealed a bony mass at the left TA region. The magnetic resonance imaging confirmed the presence of a bony mass within the substance of TA. All the clinical and biochemical laboratory tests were within normal limits. The heterotopic bone mass was removed, using a posterior longitudinal incision over the left TA, centering over the bony mass. At 6 months of follow-up, the patient had no pain, swelling, and a full range of ankle movements.

Conservative approach may suffice in most of the patients while surgery is reserved for failed conservative treatment.